Patients, who have long recovered from COVID-19 infection, continue to report breathlessness and rapid heartbeats or palpitations, and even complain of being exhausted after even a light, non-strenuous physical activity. This is probably because these patients not yet fully recovered from COVID or known as the long-haulers, have high chances of clot-formation which can lead to heart attack and brain stroke, said doctors.
Pointing out that they were witnessing a significant rise in such cases, Dr Rakesh Rai Sapra, director Cardiology, QRG said post-COVID-19 infection, there is an increased tendency of clot-formation which can lead to heart attack and brain stroke. These patients are more prone to developing clots in their hands or legs which is primarily due to the illness, the doctor said, adding that this tendency is not lifelong however, reported The Hindu.
According to an article in John Hopkins Medicine website, some of the symptoms common in coronavirus long-haulers such as palpitations, dizziness, chest pain and shortness of breath, may indicate heart problems — or, just from having been ill with COVID-19.
But, if the patient continued to experience a rapid heartbeat or palpitations, they should contact the doctor, advised the medical expert in the article. The symptoms of a rapid or irregular heart rhythm may include: feeling your heart beat rapidly or irregularly in your chest as palpitations, feeling lightheaded or dizzy, especially upon standing and chest discomfort.
A Times of India report meanwhile also highlighted studies which showed that patients with long COVID complications continued to have “higher measures of blood clotting”, which could lead to symptoms like breathlessness, fatigue and a decrease in the ability to exercise.
Coronavirus could lead to clot formation, affirmed the TOI report. The heart damage caused by COVID-19 occurs because of the formation of very small clots that block tiny blood vessels in the heart muscle. Earlier, a study published in the Journal of Thrombosis and Haemostasis found that indications of blood clots were significantly higher in the blood of patients with long COVID syndrome.
A Hindustan Times report too quoted doctors to emphasise that complications like heart attack, myocarditis, swelling of the heart, low pumping capacity, heart failure, blood clotting, and arrhythmia (abnormal heartbeat) are commonly seen in post-COVID patients.
Long-haulers with co-morbidities at higher risk
Patients with co-morbidities such as diabetes or kidney-related ailments were obviously at a higher risk. So, Dr Sapra pointed out in The Hindu that he made the patients take a test called D-dimer and if the results were significantly higher (2 to 3 times the normal range), blood thinners were prescribed.
It is not just the heart, the lungs have also become vulnerable. Since the lungs get affected in the COVID patients some patients take time to recover. Doctors recommend such patients not to indulge in heavy physical activity after recovery but to slowly step up their activities. “Enhanced physical activity will lead to compromise of oxygen in the body leading to emergency situations,” explained Dr Sapra, The Hindu reported.
Doctors claimed that heart failures in patients with long-COVID was resulting in more heart transplants. In many cases, patients need pacemakers in situations where the heart had stopped working due to respiratory failure or crippled lung or heart.
According to doctors, many people’s hearts are working only at 15-20 per cent; and such people were constantly battling breathlessness and they were left with no other option but to opt for a cardiac transplant option to survive. This is happening across the board, and with younger people as well, said doctors.
It has been suspected for a long time now but the picture is becoming clearer. Cardiac deaths in COVID-19 patients are not uncommon accounting for 10-15 per cent of deaths in people suffering from moderate to severe symptoms.
A staggering 70 per cent of COVID patients MRI’s showed long-term inflammation and scarring in the heart, predisposing people to sudden deaths either in the form of slower heart rhythms or faster heart rhythms (ventricular castellation), said Rajpal Singh, director-Interventional Cardiology & Heart Failure, Fortis Hospitals, Bangaluru, The Hindu reported.
He said sudden cardiac attacks in patients were because of inflammation of the heart muscle, known as myocarditis, or due to pulmonary embolism, thrombosis in the arteries cutting off supply to the lungs. Therefore, blood thinners were mandatory in patients with significant COVID-19 illnesses and/or in recovery from the same.
COVID patients should regularly visit a cardiologist, have an echocardiogram, and get their cardiac troponin and pro-BNP levels checked. A 24-hour call monitoring is also recommended. After two months of their recovery, patients should go for a regular heart screening, exercise or do yoga for at least half an hour and stick to a healthy diet, stay physically active and take medication, said doctors.